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Individual

GLENN THOMAS ASHWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3820 PACIFIC AVE, SUITE 101, TACOMA, WA 98418-7825
(716) 425-6295
Mailing address
3820 PACIFIC AVE, SUITE 101, TACOMA, WA 98418-7825
(716) 425-6295

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 60462145
WA
1223G0001X
General Practice Dentistry
14600
MD

Other

Enumeration date
09/20/2010
Last updated
05/19/2015
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